In sprains it is necessary to begin with slight, careful introductory massage, in the form of centripetal stroking, the pain being very severe. The strength of the manipulation must not be increased until most of the swelling is gone, and the operator must be very careful to work upon every part in the neighborhood of the joint, applying, as a rule, stroking only. Then begin kneading the muscles and tendons, always ending with stroking. The treatment is greatly assisted by water applications at night. A flannel or rubber bandage must be used to keep the swelling down. Some authors recommend movements from the beginning, but I have found the best results from the massage alone.

In contraction of the tendo Achillis, turning and rotation of the foot, also flexion and extension, ought to be used after the fifth treatment.

The weakness of the joint after a sprain is frequently relieved by massage, the operator being careful to apply properly the bandage after each seance.